In trend: September 2016
Moving towards trouble—We all know that moving house can be stressful, but according to a national cohort study published in the American Journal of Preventive Medicine (doi:10.1016/j.amepre.2016.04.011), people who have moved often during their childhood and early adolescence are at an increased risk of psychiatric illness and suicide. Data from a cohort of more than a million people born in Denmark were collected, which included the number of times participants had moved house between birth and the age of 14, and the incidence of attempted suicides, violent crimes, psychiatric illness, substance misuse, and unnatural death before the final follow-up date. Those who had moved at least once were more likely to experience attempted suicide (incidence rate ratio 2.96 (95% confidence interval 2.85 to 3.08)); psychiatric illness (2.26 (2.21 to 2.32)); violent offending (3.48 (3.37 to 3.59)); and substance abuse (3.77 (3.62 to3.93)). Since the link between childhood residential mobility and negative mental health outcomes was observed across the socioeconomic spectrum, the authors conclude that “health and social services, schools, and other public agencies should be vigilant of the psychological needs of relocated adolescents, including those from affluent as well as deprived families.”
Something in the air—If you are moving house, you’d best not move to somewhere with high levels of air pollution. An observational study published in BMJ Open (doi:10.1136/bmjopen-2015-010004) suggests that there is an association between air pollution concentrations and psychotropic drugs dispensed to children and adolescents under the age of 18. The study used data from the Swedish National Register on dispensed drugs for a range of psychiatric disorders between 1 January 2007 and 31 December 2010, and air pollution concentrations in the area where the participants lived. Out of the 552 221 eligible participants, those living in areas with higher concentrations of air pollution were more likely to have been dispensed drugs for a psychiatric problem—for every 10 µg/m increase in nitrogen dioxide, the adjusted hazard ratio was 1.09 (95% confidence interval 1.06 to 1.12). The authors suggest that oxidative stress caused by air pollution could be a possible mechanism as there are animal studies linking oxidative stress to a range of psychiatric conditions.
Potato, potat-no—If potatoes are part of your staple diet, it might be a good idea to keep an eye on your blood pressure, irrespective of your body mass index, according to a series of prospective longitudinal cohort studies published in The BMJ (doi:10.1136/bmj.i2351). The study population consisted of 62 175 women from the Nurses’ Health Study; 88 475 women from the Nurses’ Health Study II; and 36 803 men from the Health Professionals Follow-up Study—all of whom had a blood pressure reading within the normal range at baseline. They were asked to complete and return food frequency questionnaires at regular intervals, and self reported diagnoses of hypertension via questionnaire every two years. Compared with the consumption of less than one serving per month, the hazard ratios for four or more servings per week were 1.11 (95% confidence interval 0.96 to 1.28; P for trend=0.05) for baked, boiled, or mashed potatoes; 1.17 (1.07 to 1.27; P for trend=0.001) for French fries; and 0.97 (0.87 to 1.08; P for trend=0.98) for potato chips. The authors point out that although weight gain is associated with potato intake—which is in turn associated with high blood pressure—their study controlled for weight change and body mass index. This means that it is unlikely that changes in weight could completely explain the association between potato intake and the risk of hypertension found in the study.
Warning (camera) shots—Pictures really do speak a thousand words when it comes to getting people to give up smoking. A randomised clinical trial published in JAMA Internal Medicine (doi:10.1001/jamainternmed.2016.2621) recruited 2149 adult US smokers for a four week period, randomly assigning participants to receive either cigarette packs with text only warnings or with pictorial warnings. The smokers attended a follow-up visit each week where they completed computer surveys in which they were asked whether in the past week they had stopped smoking for one day or longer. In intention to treat analyses, 40% of those assigned to receive packs with pictorial warnings tried to quit smoking during the four week trial, compared to 34% of those assigned to receive text only warnings (odds ratio 1.29, 95% confidence interval 1.09 to 1.54). A possible mechanism for this effect is that “pictorial warnings elicit stronger initial affective and cognitive reactions, such as fear and thinking about the harms of smoking,” motivating smokers to quit more effectively. The authors point out that although the effects they observed were modest, “they could have a substantial benefit across the population of US smokers.”
Protect your melons—If you constantly munched on fruit when you were a teenager, you might have reduced your future risk of breast cancer. A prospective cohort study published in The BMJ (doi: 10.1136/bmj.i2343) looked at incidents of invasive breast cancer in premenopausal women aged between 27 and 44 years from the Nurses’ Health Study II. It found that of the 3235 cases of invasive breast cancer recorded during follow-up to 2013: 1347 cases were among women who had completed a questionnaire about their diet during adolescence (defined as aged between 13 and 18 years). The study found that those who had consumed the highest amount of fruit (a median intake of 2.9 servings per day) were 25% less likely to be diagnosed with premenopausal breast cancer (hazard ratio 0.75 (95% confidence interval 0.62 to 0.90; P=0.01 for trend)) compared to those who had the lowest intake of fruit (median intake of 0.5 servings per day). The authors conclude that if this “apparent risk reduction is applied to lifetime risk of breast cancer, the absolute number of breast cancers that could potentially be prevented by higher intake of fruits would be substantial.”
Working nine to nine—If you’re a workaholic, you might be more likely to also have a psychiatric disorder, such as anxiety, depression, obsessive-compulsive disorder (OCD), or attention-deficit/hyperactivity disorder (ADHD), than your colleagues with a less work-centric approach to life. A PLOS ONE cross sectional study (doi:10.1371/journal.pone.0152978) used a web based survey to assess symptoms of psychiatric disorders and “workaholism” among 16 426 workers recruited to the study via advertisements in major Norwegian newspapers. The study found that workaholics—the participants who met the criteria in the Bergen Work Addiction Scale—were more likely to meet the clinical criteria for ADHD than their non-workaholic counterparts (32.7% v 12.7% respectively, P<0.001); OCD (25.6% v 8.7% respectively, P<0.001); anxiety (33.8% v 11.9% respectively, P<0.001); and depression (8.9% v 2.6% respectively, P<0.001). The authors write that their study “highlights the relevance of further investigating underlying neurobiological deviations related to the workaholic behaviour.” They also point out that “more research is needed to examine whether workaholism is totally negative for all individuals as it may be that workaholism may serve an important structuring function for those with mental health problems and those with social dysfunction.”
Compiled by Katy Bettany
- Published: 28 October 2016
- DOI: 10.1136/sbmj.i3589